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Transarterial Infusion of Epirubicin and Cisplatin Combined With Systemic Infusion of 5-Flurouracil Versus Sorafenib for Hepatocellular Carcinoma With Refractoriness of Transarterial Chemoembolization Using Doxorubicin.

Abstract
Transarterial chemoembolization using doxorubicin (TACE-DOX) is an effective therapy for advanced hepatocellular carcinoma (HCC). However, there are limited options for patients with TACE refractoriness. We compared the effectiveness between sorafenib and transarterial chemolipiodolization using epirubicin and cisplatin combined with systemic infusion of 5-fluorouracil (5-FU; TACL-ECF) in patients with previous TACE-DOX refractoriness. We retrospectively analyzed 742 consecutively enrolled cohort patients who received TACE-DOX as the first-line therapy for HCC. Among the 94 patients who failed with TACE-DOX, 49 patients were treated with TACL-ECF and 45 patients were treated with sorafenib as a rescue therapy. The TACL-ECF regimen comprised transarterial infusion of epirubicin and cisplatin combined with systemic infusion of 5-FU. Of the 94 patients, 22 and 72 patients were in Barcelona Clinic Liver Cancer stages B and C, respectively; 66% patients were classified as having Child-Pugh class A (CPC A). Overall survival (OS) after rescue therapy did not differ between the sorafenib and TACL-ECF groups (4.1 months vs 6.4 months, P = .355). Progression-free survival (PFS) did not differ between the sorafenib and TACL-ECF groups (2.8 months vs 3.5 months, P = .629). Adverse events of CTC grade 3/4 occurred more frequently in the sorafenib group than in the TACL-ECF group (P = .024). The present study showed that the OS and PFS did not differ between patients given rescue TACL-ECF therapy and those given sorafenib therapy. The TACL-ECF treatment was better tolerated than sorafenib. The TACL-ECF might be considered as an alternative therapy for the patients with TACE-DOX refractoriness, especially CPC B and sorafenib-intolerant patients.
AuthorsSun Hong Yoo, Jung Hyun Kwon, Soon Woo Nam, Jong Yul Lee, Young Woon Kim, Dong Jae Shim, Sung Won Lee, Jeong Won Jang
JournalCancer control : journal of the Moffitt Cancer Center (Cancer Control) 2020 Apr-Jun Vol. 27 Issue 2 Pg. 1073274820935843 ISSN: 1526-2359 [Electronic] United States
PMID32583687 (Publication Type: Journal Article)
Chemical References
  • Epirubicin
  • Doxorubicin
  • Sorafenib
  • Cisplatin
  • Fluorouracil
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
  • Carcinoma, Hepatocellular (pathology, therapy)
  • Chemoembolization, Therapeutic (methods)
  • Cisplatin (administration & dosage)
  • Combined Modality Therapy
  • Disease Progression
  • Doxorubicin (administration & dosage)
  • Drug Resistance, Neoplasm
  • Epirubicin (administration & dosage)
  • Female
  • Fluorouracil (administration & dosage)
  • Humans
  • Liver Neoplasms (pathology, therapy)
  • Male
  • Middle Aged
  • Retrospective Studies
  • Sorafenib (administration & dosage)
  • Survival Rate
  • Treatment Outcome

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